56例新型冠状病毒肺炎患者生化指标及IgM、IgG抗体检测结果分析

左晓娜; 齐发梅; 坚娜娜; 石福娜; 范强; 张晓艳

doi:10.19428/j.cnki.sjpm.2020.20411

56例新型冠状病毒肺炎患者生化指标及IgM、IgG抗体检测结果分析

Blood biochemical indicators, IgM and IgG antibodies in 56 confirmed and suspected COVID-19 cases

摘要

摘要:
目的分析新型冠状病毒肺炎(新冠肺炎)患者生化指标及IgM、IgG抗体检测结果的变化，为新冠肺炎的有效防控提供依据。
方法收集甘肃省人民医院及甘肃省西固区人民医院2020年1—3月收治的确诊和疑似新冠肺炎患者56例，分为核酸阳性+CT阳性组、核酸阳性+CT阴性组、核酸阴性+CT阴性组。所有患者进行新型冠状病毒核酸检测和胸部CT检查，并采集患者的空腹静脉血检测总蛋白、白蛋白、总胆红素、谷丙转氨酶、谷草转氨酶、碱性磷酸酶、γ-谷氨酰转肽酶、肌酸激酶、乳酸脱氢酶等9项生化指标。用SPSS 22.0统计软件分析3组患者生化指标的检测结果，并分析核酸阳性患者不同时间点的IgM、IgG抗体检测结果。
结果3组间谷丙转氨酶、谷草转氨酶、碱性磷酸酶、乳酸脱氢酶的均值差异有统计学意义(P < 0.05)，总蛋白、白蛋白均值差异无统计学意义(P>0.05)。3组间各项指标的ROC曲线分析显示，谷草转氨酶曲线下面积最大为0.834，谷丙转氨酶灵敏度最高为1.000，总胆红素特异度最高为0.927，综合3项指标谷草转氨酶在新冠肺炎患者的诊疗中诊断效能最高，灵敏度、特异度、曲线下面积分别为0.786、0.854、0.834。IgM、IgG抗体检测结果显示，患者确诊10 d后，检测16例新冠肺炎患者的IgG抗体, 阳性率为68.75%；确诊14 d后，检测10例患者的IgG抗体, 阳性率为100.00%。
结论谷草转氨酶在新冠肺炎患者的诊疗中具有较高的诊断效能。

Abstract:
ObjectiveTo provide reliable indicators for effective prevention and control of COVID-19, we examined the biochemical indicators as well as anti-SARS-CoV-2 IgM and IgG antibodies in confirmed and suspected COVID-19 patients.
MethodsA total of 56 confirmed and suspected COVID-19 cases quarantined during January-March, 2020 in Gansu Provincial People′s Hospital and People′s Hospital of Xigu District, Gansu Province were included.Based on the results of nucleic acid testing and CT scan finding, they were divided into three groups: positive in both nucleic acid testing and CT scan finding; positive in nucleic acid testing but negative in CT scan finding; negative in both nucleic acid testing and CT scan finding.COVID-19 viral nucleic acid was detected and chest CT scan was performed.The following biochemical indicators were examined: total protein, albumin, total bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, γ-glutamyltranspeptidase, creatine kinase and lactate dehydrogenase.SPSS 22.0 statistical software was used to analyze the differences in the biochemical indicators among these three groups, as well as the temporal trend of IgM and IgG antibodies at different points of time.
ResultsThere were significant differences in the mean values of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and lactate dehydrogenase between these three groups (P < 0.05), whereas no significant difference in the mean value of total protein and albumin (P>0.05).ROC curve indicated that aspartate aminotransferase had the largest maximum area under the curve (AUC, 0.834), whereas alanine aminotransferase had the highest sensitivity (1.0) and total bilirubin had the highest specificity (0.927).Thus, aspartate transaminase provided the best prediction for the diagnosis of COVID-19, with sensitivity of 0.786, specificity of 0.854, and the maximum AUC of 0.834.In 12 of 16 confirmed COVID-19 patients tested IgG positive after 10 days of diagnosis, and 10 of 10 confirmed COVID-19 patients tested IgG positive after 14 days of diagnosis.
ConclusionAspartate aminotransferase may be the most useful indicator in the diagnosis of COVID-19.

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